Questions regarding neonatology

[neo2be]

I am an incoming M1 at a US MD school with way too much time on their hands prior to start of school and a penchant for thinking lots about my choice of specialty in the future. It has long been a dream of mine to go into neonatology and I'm hoping some of you could answer some questions I have about it. Some of these questions have been addressed in the past, but those threads seem somewhat dated at this point. I'll start with only some so as to not overwhelm:

- At this point in my education, are there any steps I can take to getting my foot in the door? Perhaps research pertaining specifically to pediatrics/neonatal medicine during med school can still give me a head start?

-Exactly how competitive are neonatology fellowships at this time? I have taken a gander at recent NRMP data, but I'm having trouble contextualizing the raw data from a qualitative perspective. One person has informed me that it's been getting more competitive but it'd be nice to hear more opinions on that. How much does competitiveness of pediatric residency matter?

-How does the increased emphasis on pay-for-performance models affect neonatology, a subspecialty in which "success" is increasingly more conceptualized outside the binary of survival/morbidity?

- In general, are you optimistic about the future of the profession? What are some things that you hope will change (at least by the time I can enter fellowship =D )?

Thank you so much to all of you in advance!!

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[mvenus929]

1. Research in general is good regardless of the residency choice you end up making. Neonatologists, especially at academic centers, are generally pushed to do research, so it should be fairly easy to get involved with a project if you would like.

2. They are becoming more competitive in the context of peds fellowships in general. There are people who go unmatched every year, so it's becoming more common to take time off between residency and fellowship (at least, that's what I see a good portion of the residents in my program doing, and we have a lot of hands-on time with babies in our program).

3. The neonatology department is probably the most lucrative department outside of some of the complex surgeries. It's a huge money-maker for the hospital.

4. I'll leave it to others to address, since I"m not going into neo.

 

[neo2be]

2. They are becoming more competitive in the context of peds fellowships in general. There are people who go unmatched every year, so it's becoming more common to take time off between residency and fellowship (at least, that's what I see a good portion of the residents in my program doing, and we have a lot of hands-on time with babies in our program).

Is it still relatively uncompetitive compared to subspecialties in adult medicine? And are you saying those people take time off to increase their competitiveness for acceptance to the neo fellowship? What benefit does that confer? Thanks!!

 

[mvenus929]

Is it still relatively uncompetitive compared to subspecialties in adult medicine? And are you saying those people take time off to increase their competitiveness for acceptance to the neo fellowship? What benefit does that confer? Thanks!!

That is my understanding. Granted, I was never interested in doing internal medicine, so I never explored it further.

The reasons people in my program take time off are diverse. First, applying to fellowship during residency is hard in terms of scheduling and funding. Second, taking time off allows you to study for your gen Peds boards without worrying about fellowship responsibilities. Third, time off gives you more time to work on research that might look better on your application.

 

[oldbearprofessor]

- At this point in my education, are there any steps I can take to getting my foot in the door? Perhaps research pertaining specifically to pediatrics/neonatal medicine during med school can still give me a head start?

-Exactly how competitive are neonatology fellowships at this time? I have taken a gander at recent NRMP data, but I'm having trouble contextualizing the raw data from a qualitative perspective. One person has informed me that it's been getting more competitive but it'd be nice to hear more opinions on that. How much does competitiveness of pediatric residency matter?

-How does the increased emphasis on pay-for-performance models affect neonatology, a subspecialty in which "success" is increasingly more conceptualized outside the binary of survival/morbidity?

- In general, are you optimistic about the future of the profession? What are some things that you hope will change (at least by the time I can enter fellowship =D )?

Thank you so much to all of you in advance!!

1. Research is always helpful for fellowships, but not all that crucial in the early part of med school.
2. Moderately as compared to other pedi fellowship. It never hurts to have been at a top ranked pedi program, but most excellent programs have many fellows not from such programs.
3. Fee-for-service is still the predominant mode of payment in neo. Quality measures are often used in group evaluation, since each patient will have multiple doctors in most places. There are large national databases used to track these with the intent of finding and improving areas of weakness, not determining payment.
4. Very, I hope we continue to improve long-term outcomes.